Endotracheal tube holder

ABSTRACT

An endotracheal tube holder adapted to supportively balance, suspend, harness, and reliably hold the tube in given position in the trachea and mouth of a patient. A prescribed length of adhesive tape has a median portion wrapped around and adhesively attached to a predetermined portion of the tube. The free end portions of the tape are tautened lengthwise across the patient&#39;&#39;s left and right cheeks, respectively, and are adjustably and detachably fastened to clamps. These clamps are oriented with like loops, more particularly, a pair of ear encircling adapters. These adapters are made from plastic tubing and are applied to the ears of the patient prior to intubation, if desired. The rearward curvate end portion of each adapter is lodged and seated in the deepest groove behind the cartilage directly above the earlobe and adhesively held in place. The adapter proper encircles the ear, resides flatwise against the patient&#39;&#39;s cheek and locates a complemental clamp in the place and position desired. Accordingly, the clamped and harnessed tape functions to properly suspend and prevent displacement of the tube.

United States Patent 1 1 Arrott 51 Jan.30,1973

[541 ENDOTRACHEAL TUBE HOLDER [76] Inventor: Janice J. Arrott, 7625Mountain Road, N.E., Albuquerque, N. Mex. 87110 [22] Filed: Feb. 16,1971 [21] Appl. No.1 115,438

[52] US. Cl ..128/351, 128/208, 128/D1G. 26 [51] Int. Cl. ..A6lm 25/02[58] Field of Search..128/l33, 206, 208, 348, 349 R,

128/350 R, 351, DIG. 26, 146.7; 24/5,8l HS [56] References Cited UNITEDSTATES PATENTS 3,161,199 12/1964 Shaw ..128/348 2,820,457 1/1958Phillips... ..128/351 2,908,269 10/1959 Cheng ..128/351 X 2,168,7058/1939 Francisco et al. ..128/206 2,159,947 5/1939 Gansel ..128/3493,013,556 12/1961 Galleher ..128/146.7 1,949,863 3/1934 Hay ..128/127Primary Examiner-Dalton L. Truluck Att0rneyClarence A. OBrien and HarveyB. Jacobson [57] ABSTRACT An endotracheal tube holder adapted tosupportively balance, suspend, harness, and reliably hold the tube ingiven position in the trachea and mouth of a patient. A prescribedlength of adhesive tape has a median portion wrapped around andadhesively attached to a predetermined portion of the tube. The free endportions of the tape are tautened lengthwise across the patients leftand right cheeks, respectively, and are adjustably and detachablyfastened to clamps. These clamps are oriented with like loops, moreparticularly, a pair of ear encircling adapters. These adapters are madefrom plastic tubing and are applied to the ears of the patient prior tointubation, if desired. The rearward curvate end portion of each adapteris lodged and seated in the deepest groove behind the cartilage directlyabove the earlobe and adhesively held in place. The adapter properencircles the ear, resides flatwise against the patients cheek andlocates a complemental clamp in the place and position desired.Accordingly, the clamped and harnessed tape functions to properlysuspend and prevent displacement of the tube.

8 Claims, 8 Drawing Figures Endolrachae/ Tube PATENTEDJAN 30 ms SHLU Il]? 2 Janice J. Arm/l I.\' VENTOR.

I PATENTEDJAI 30 I973 Fig.7

SHEEI 2 BF 2 Endolrachae/ Tube Janice J. Arrafl l.\'l EXTORENDOTRACI'IEAL TUBE HOLDER This invention relates to hospital appliancesand surgical devices and has to do with a device which is expresslydesigned and susceptible of practical and unhampered use when the useris called upon to locate and reliably hold an endotracheal tube in thetrachea and mouth of a patient with respiratory problems, and which alsofunctions to stabilize the tube in the trachea and mouth of patientsundergoing general endotracheal anesthesia (a common anesthetictechnique).

Persons who are conversant with the use and handling of endotrachealtubes are aware that it is the prevailing practice to employ ribbon-typeadhesive tape which, in most cases provides counter traction to unduepull on the tube. Unfortunately, such tapes, which are frequently madewet from uncontrolled saliva, lose retentive properties and areperilously detached. The herein disclosed tube harnessing and retainingappliance can be conveniently applied, prior to intubation, if desired.To the ends herein desired loop-type adapters are applied and reliablyattached to the patients ears and are equipped with readily accessibleclamps which reside against the patients cheeks and are in position topermit the free ends of the tape to be adjustably and releasablyanchored and held in set positions, with the result that the tube can bestabilized and maintained in its intended locale.

For background information and as indicative, generally stated, of theprior art pertaining to insertable and removable endotracheal tubes,reference can be made to the tube holder shown in the patent to Peter A.Cheng U.S. Pat. No. 2,908,269 which embodies, unlike the presentinvention, a plurality of relatively movable component parts tocompensate for different sizes of endotracheal tubes.

In carrying out the principles of the instant concept, tape anchoringear encircling plastic adapters are provided and are such inconstruction and adaptability that they permit unhampered access to mostof the patients head, face and neck and are applicable and usable withtime saving expediency. Its presence on the patient allows surgery to bedone on most areas, except behind the ears and is feasible for use inthe operating room. Not only does it give free access for surgeons tooperate on all parts of the head (except the ears) and neck (front andback); it provides the counterbalance for holding the tube secure in themany positions patients are placed in when undergoing various types ofsurgery, for example, prone, sitting and lateral. Then, too, thedisclosed adaptation is simple and practical in construction, issusceptible of mass production, can be made of economical and disposablematerials, can be acceptably used in conjunction with commonly used biteblocks and in all other ways serves its intended purposes withefficiency and reliability.

Briefly, and construing the over-all concept in a combination sense theassociatively cooperable components have to do with an endotracheal tubeof a conventional type, and a length of commonly used ribbonlikeadhesive tape which, as shown, has a median portion not only properlywrapped around but adhesively and retentively attached to apredetermined portion of the tube and has like free end portions whichare adapted to be uniformly stretched lengthwise across the left andright cheeks of the patient. A pair of like as well as companionadapters are utilized and designed and expressly adapted to be properlyoriented with and temporarily attached and attached to and supported bythe patients ears. These adapters have means by way of which the freeend portions of the tapes can be cooperatively attached thereto and thusharnessed and suspended and held in a given tube stabilizing position.For best results each adapter comprises a horizontal elongated plastictube loop of a size and shape that it encompasses and is hung over theassociated ear and resides flatwise, when in use, against the coactingcheek of the patient and in which position the clamp on the forward endassumes an ideal position to facilitate lining up and attaching the freeend of the adhesive tape thereto.

These together with other objects and advantages which will becomesubsequently apparent reside in the details of construction andoperation as more fully hereinafter described and claimed, referencebeing had to the accompanying drawings forming a part hereof, whereinlike numerals refer to like parts throughout, and in which:

FIG. 1 is a view in front elevation showing the tube, the centrallyattached adhesive tape, both the free end portions of the tape and theleft and right tape anchoring and harnessing adapters.

FIG. 2 is a view in side elevation showing one side of the head and faceof the patient and likewise showing the adapter, clamp and an endportion of the adhesive tape with the median portion of the tapeattached to an in-use endotracheal tube.

FIG. 3 is a section on the line -33 of FIG. 2.

FIG. 4 is a view on an enlarged scale and appearing in perspective andshowing the over-all tube holder and how the component parts areconstructed, cooperatively related and used.

FIG. 5 is a section of fragmentary type and suitably presented and takenon the plane of the vertical section line 5-5 of FIG. 4 looking in thedirection of the arrows.

FIG. 6 is a view at right angles to FIG. 5 and taken on the plane of thesection line 6-6 of FIG. 5.

FIG. 7 is a horizontal detail section on the line 7-7 of FIG. 5.

FIG. 8 is an enlarged detail view with parts in section and elevationtaken on the plane of the line 88 of FIG. 4.

The manner in which the endotracheal tube 10 is inserted and used inbrought out, satisfactorily it is believed, in FIGS. 1 and 2 wherein itwill be noted that a portion 12 of the tube is inserted into the tracheaof the patient. A portion 14 of the tube is centered and insertedbetween the lips into the patients mouth. In carrying out the principlesof the present invention it has been found desirable to provide theportion exteriorly of the mouth on diametrically opposite sides withstrips or bands of adhesive material as at 16 to facilitate attachingthe tape. The tape is of the usual ribbon-like flexible form and isdenoted generally stated by the numeral 18. In practice, the adhesivecoated side (not detailed) of the tape is wrapped around the tube as at20 (FIGS. 1, 2 and 4). Each end portion is denoted at 22 and theterminal thereof is denoted at 24. It is obviously the significantpurpose of the invention to stabilize and maintain the tape so that itwill retain the tube 10 against undesirable displacement from itsintended in-use position.

The aforementioned elongated loop-type ear encircling adapters (whichare identical in construction at the left and right) are properlydevised and used to anchor and harness the tape ends 24. Each adapter isdenoted by the numeral 26. Considering the over-all adapter it is ofelongated loop form and of requisite size and shape to not only embracethe ear but to reside substantially flatwise against the adjacent cheekof the patient. Broadly the adapter has a rearward end portion which isattached to the ear (FIG. 3) and a forward end portion which carriestape fastening means, for example, a specially constructed clamp as at28 (FIG. 4). More specifically, the principal component part of theadapter is approximately C-shaped in side elevation and embodies a bightportion 30 and a pair of upper and lower longitudinally bowed legs 32which have turned in laterally directed free end portions 34. The bightportion and legs are made of frequently plastic tubing the hollowportion of which contains a suitable length of malleable wire 36. Thewire is manually bendable to assume and maintain a given shape. It willbe noted that the respective forward end portions of the wire terminateshort of the (FIGS. end portions 34 (see FIG. As also brought out inFIG. 5 in particular, a stiff metal spreader or rod 39 serves to adjointhe end portions 34. This rod has a median portion 38 and upper andlower end portions 40 which are fitted telescopingly into the lateralend portions 34 in a manner to bridge the gap between the same wherebyto thus complete the encircling loop and to accommodate the pivotallyattached tape anchoring clamp 42.

With further reference to the bight portion 30 of the loop-type adaptersit may well be mentioned that the adapters can be and frequently areapplied prior to intubation, if desired which means that if it isdesirable to place the bight portion of the loop or adapter around eachear. It is advisable to hold the ear forward and to place the adhesivecoating or media 31 (FIGS. 3 and 4) in the deepest groove behind thecartilage directly above the earlobe. This procedure functions to locatethe over-all adapter and serves to poise the clamp 42 in a ready-to-useposition. The clamp can be made of noncorrodible material and comprisesa first or inner jaw 44 the forward edge of which is provided with alaterally directed flange 46 (FIG. 7) which has a serrated edge 48 thusproviding tape engaging teeth. The other vertical edge of the jaw isprovided with a suitably curved clamp mounting member. This is to saythe edge 50 (FIG. 7) has a pivoted knuckle or sleeve 52 which isproperly split and is retentively bent around the portion 38 of theaforementioned rod 39 (FIG. 5). The exterior jaw is denoted at 54 andhas its upper end joined by a bendable hinging web 56 to the upper endof the jaw 44. The lower end is provided with a lateral lip flange 58which can be pressed toward the lower edge of the jaw 40 and hasembossed detents 60 which serve to hold it in a set position, asillustrated in phantom lines in FIG. 6. It is also within the purview ofthe invention to provide a film of adhesive media (not detailed) on ithe interior of the jaw 44 so as to allow the adhesive to hold the overall device to the cheek until the tape holding the endotracheal tube inplace is pressed into position between the closable jaws 44 and 46 ofthe aforementioned clamp 42. It can be added too that it is within thepurview of the concept to provide the cheek contacting surface of thejaw 44 with pad means (not shown) which can be impregnated with adhesivemedia. The purpose is to temporarily set the clamp after the adapter hasbeen positioned and to thus maintain the jaws open and to facilitateplacing the portions 22 and 24 of the adhesive tape in correct positionand relationship.

Experience has shown that the spreader rod 39 is a significant andimportant part not only in mounting the clamp means 42 but also instabilizing the terminal ends 34 of the plastic tubing and to make surethat the two ends are kept spread apart to avoid accidental displacementof the' adapter from the ear. Further, the adherence of the adhesivecoated bight portion 30 is important in maintaining the adapter so thatthe part 30 is situated in the deepest groove behind the cartilage whichlies just above the level of the earlobe. Experience has shown that ifthe adapter is not correctly located it would be possible for it to pulloff the ear and thus interfere with proper anchorage, stabilization andmaintenance of the tube 10.

The tape-end positioning tautening and anchoring adapters equalize,suspend and anchor the terminal left and right free end portions of theadhesively attached tube centering and retaining tape. Conjointly thecomponent parts contribute a proportionate share to stabilizing the tubeand securing and maintaining the same in a given locale, thus servingnot only the needs of the patient but purposes of the nurses, doctorsand all personnel who are called upon to achieve the end result desired.

In most instances an endotracheal tube must be passed with direct visionof the vocal chords with the lighted instrument and this aspect of theproblem has been kept in mind in working out and perfecting the instantappliance. Further, the appliance is such in construction that the tubecan be removed while the adapters and clamps thereon remain in place. Itfollows that the disclosed invention well serves the purposes for whichit has been devised.

The foregoing is considered as illustrative only of the principles ofthe invention. Further, since numerous modifications and changes willreadily occur to those skilled in the art, it is not desired to limitthe invention to the exact construction and operation shown anddescribed, and accordingly all suitable modifications and equivalentsmay be resorted to, falling within the scope of the invention.

What is claimed as new is as follows:

1. In combination, an endotracheal tube having exterior adhesive coatedsurfaces, a length of flexible adhesive tape having a median portionsecurely wrapped around and adhesively and retentively attached to aprescribed portion of said tube and having like free end portions whichare adapted to be uniformly and tautly stretched lengthwise across theleft and right cheeks of the patient, a pair of companion adapters whichare designed and adapted to completely encompass the patients left andright ears, said adapters having jaw means by way of which the free endportions of said tapes are detachably and adjustably attached to saidadapters and thus harnessed and held in given tube positioning,suspending and stabilizing positions, each adapter comprising ahorizontally elongated loop of a size and shape that it not onlyencompasses but is supportively hung over the associated ear and residesflatwise against the coacting check of the patient, said loop having anarcuately curved rearward end which is conformable to and is adapted tobe lodged and seated in the deepest groove of the ear and behind thecartilage which lies just above the earlobe, said rearward end beingcoated with adhesive media which assists in seating and function toretain the loop and the complemental adapter in its given position.

2. The combination defined in and according to claim 1, and wherein eachjaw means is mounted on and is carried by a forward end portion of theassociated adapter and comprises a clamp.

3. The combination defined in and according to claim 1, and wherein eachjaw means is carried by a forward end portion of the associated adapterand comprises a clamp, said jaw means comprising a pair of openable andclosable jaws between which a free end portion of the cooperable tapecan be passed and between which said end portion can be retentively butremovably and adjustably clenched and held.

4. The combination defined in and according to claim 3, and whereinthere are inner and outer jaws having upper ends hingedly joined by amalleable bend, said inner jaw having a flat face to reside firmly in agiven position on the associated cheek, said jaw having a lateraloutstanding serrated flange providing a toothed tape securing lip, saidouter jaw having a portion which is manually bendable toward and fromand is clampingly cooperable with said toothed lip.

5. An ear supported adapter for use as a component part of anendotracheal tube holder comprising: a length of plastic tubingcontaining and encasing a corresponding length of malleable wire havinglike end portions terminating short of the respective free forward endsof said tubing, said wire-encased tubing being bent upon itselfintermediate its ends into elongated C-shaped form and providinglongitudinally bowed upper and lower legs joined at their rearward endsby a curvate bight portion and having free forward ends which are turnedin toward each other and aligned but are spaced apart, a rigid spreaderrod positioned between said forward ends, bridging said space and havingend portions telescoping retentively into said free forward ends andcooperating therewith and with said legs and defining an endless loopwhich is designed and adapted to (l) wholly encompass and (2) hang overa selected ear whereby the loop can assume a flatwise position againstthe patients cheek, and a tapeend accommodating and anchoring clamppivotally mounted on and carried by a median portion of said spreaderrod.

6. The adapter defined in and according to claim 5, and wherein saidclamp comprises a pair of openable and closable jaws between which afree end portion of the cooperable tape can be passed and between whichsaid end portion can be retentively but removably clenched and held,whereby the over-all tape functions to not only locate the wrappedportion of the tube but serves to prevent displacement by equalizing andstabilizing the tubes position in the patients trachea and mouth.

7. The combination defined in and according to claim 6, and whereinthere are inner and outer jaws having upper ends hingedly joined by amalleable bend,

said inner jaw having a flat face to reside firmly in a given positionon the associated cheek, said aw having a lateral outstanding serratedflange providing a toothed tape securing lip, said outer jaw havingportion which is manually bendable toward and from and is clampinglycooperable with said toothed lip.

8. The adapter defined in and according to claim 6, and wherein saidbight portion is coated with adhesive media and is expressly designedand conformingly adapted to be insertably and removably seated in thedeepest groove in the patients ear just above the lobe of said ear.

1. In combination, an endotracheal tube having exterior adhesive coatedsurfaces, a length of flexible adhesive tape having a median portionsecurely wrapped around and adhesively and retentively attached to aprescribed portion of said tube and having like free end portions whichare adapted to be uniformly and tautly stretched lengthwise across theleft and right cheeks of the patient, a pair of companion adapters whichare designed and adapted to completely encompass the patient''s left andright ears, said adapters having jaw means by way of which the free endportions of said tapes are detachably and adjustably attached to saidadapters and thus harnessed and held in given tube positioning,suspending and stabilizing positions, each adapter comprising ahorizontally elongated loop of a size and shape that it not onlyencompasses but is supportively hung over the associated ear and residesflatwise against the coacting cheek of the patient, said loop having anarcuately curved rearward end which is conformable to and is adapted tobe lodged and seated in the deepest groove of the ear and behind thecartilage which lies just above the earlobe, said rearward end beingcoated with adhesive media which assists in seating and function toretain the loop and the complemental adapter in its given position. 1.In combination, an endotracheal tube having exterior adhesive coatedsurfaces, a length of flexible adhesive tape having a median portionsecurely wrapped around and adhesively and retentively attached to aprescribed portion of said tube and having like free end portions whichare adapted to be uniformly and tautly stretched lengthwise across theleft and right cheeks of the patient, a pair of companion adapters whichare designed and adapted to completely encompass the patient''s left andright ears, said adapters having jaw means by way of which the free endportions of said tapes are detachably and adjustably attached to saidadapters and thus harnessed and held in given tube positioning,suspending and stabilizing positions, each adapter comprising ahorizontally elongated loop of a size and shape that it not onlyencompasses but is supportively hung over the associated ear and residesflatwise against the coacting cheek of the patient, said loop having anarcuately curved rearward end which is conformable to and is adapted tobe lodged and seated in the deepest groove of the ear and behind thecartilage which lies just above the earlobe, said rearward end beingcoated with adhesive media which assists in seating and function toretain the loop and the complemental adapter in its given position. 2.The combination defined in and according to claim 1, and wherein eachjaw means is mounted on and is carried by a forward end portion of theassociated adapTer and comprises a clamp.
 3. The combination defined inand according to claim 1, and wherein each jaw means is carried by aforward end portion of the associated adapter and comprises a clamp,said jaw means comprising a pair of openable and closable jaws betweenwhich a free end portion of the cooperable tape can be passed andbetween which said end portion can be retentively but removably andadjustably clenched and held.
 4. The combination defined in andaccording to claim 3, and wherein there are inner and outer jaws havingupper ends hingedly joined by a malleable bend, said inner jaw having aflat face to reside firmly in a given position on the associated cheek,said jaw having a lateral outstanding serrated flange providing atoothed tape securing lip, said outer jaw having a portion which ismanually bendable toward and from and is clampingly cooperable with saidtoothed lip.
 5. An ear supported adapter for use as a component part ofan endotracheal tube holder comprising: a length of plastic tubingcontaining and encasing a corresponding length of malleable wire havinglike end portions terminating short of the respective free forward endsof said tubing, said wire-encased tubing being bent upon itselfintermediate its ends into elongated C-shaped form and providinglongitudinally bowed upper and lower legs joined at their rearward endsby a curvate bight portion and having free forward ends which are turnedin toward each other and aligned but are spaced apart, a rigid spreaderrod positioned between said forward ends, bridging said space and havingend portions telescoping retentively into said free forward ends andcooperating therewith and with said legs and defining an endless loopwhich is designed and adapted to (1) wholly encompass and (2) hang overa selected ear whereby the loop can assume a flatwise position againstthe patient''s cheek, and a tape-end accommodating and anchoring clamppivotally mounted on and carried by a median portion of said spreaderrod.
 6. The adapter defined in and according to claim 5, and whereinsaid clamp comprises a pair of openable and closable jaws between whicha free end portion of the cooperable tape can be passed and betweenwhich said end portion can be retentively but removably clenched andheld, whereby the over-all tape functions to not only locate the wrappedportion of the tube but serves to prevent displacement by equalizing andstabilizing the tube''s position in the patient''s trachea and mouth. 7.The combination defined in and according to claim 6, and wherein thereare inner and outer jaws having upper ends hingedly joined by amalleable bend, said inner jaw having a flat face to reside firmly in agiven position on the associated cheek, said jaw having a lateraloutstanding serrated flange providing a toothed tape securing lip, saidouter jaw having portion which is manually bendable toward and from andis clampingly cooperable with said toothed lip.